State plans to close Minnesota's only psychiatric nursing home
by Tom Robertson, Minnesota Public Radio
July 26, 2004

Ah-Gwah-Ching is a sprawling, 175-acre campus on rolling hills near the south shore of Leech Lake. There are 16 buildings on the site, though many have been mothballed. The main facility, pictured above, houses about 100 mentally ill patients. State officials want to shut down the facility, saying it's too expensive to operate. (MPR Photo/Tom Robertson)

The Ah-Gwah-Ching Center near Walker is the state's only psychiatric nursing home. If some people have their way, it will soon be shut down. Ah-Gwah-Ching is located on a sprawling, 175-acre campus. It was once the state's premier home for elderly people with behavior problems and severe mental illness. But treatment trends now favor smaller, community based facilities over large institutions. Still, some northern Minnesota lawmakers are fighting to keep Ah-Gwah-Ching open. They say an aging prison population will mean a greater need for a secure facility for sexual or violent offenders.

Walker, Minn. —
The Ah-Gwah-Ching Center got its name from the Ojibwe word for "out of doors." The campus is massive -- with 16 buildings scattered on rolling, pine-forested hills. It juts against the south shore of Leech Lake. From 1907 to 1962, Ah-Gwah-Ching served as Minnesota's tuberculosis sanitorium. Some 14,000 TB patients came there for fresh air and cutting-edge treatment. It's on the National Register of Historic Places.

For the last 40 years, Ah-Gwah-Ching has been a mental institution. It now represents a treatment style that's gone out of fashion. The facility is home to psychiatric patients prone to violent or inappropriate behavior. Ah-Gwah-Ching serves the needs of two state agencies. The Department of Human Services runs the place, while the Department of Corrections keeps a handful of prisoners there, mostly sex offenders and murderers who need specialized care.

Ah-Gwah-Ching's population has dwindled to only about 100 residents -- half of what it was just a decade ago. State officials say the campus is inefficient. Many of its buildings have been mothballed. The state plans to shut down Ah-Gwah-Ching by 2006.

State Rep. Larry Howes, R-Walker, has been fighting for years to keep Ah-Gwah-Ching open, primarily to save the more than 175 jobs there. Howes says the state has spent millions maintaining the campus, and closing it would be a waste.

"There are some buildings that, yes, they're aged and they should probably be removed," Howes said. "But when you look at the main core facility and what it would cost to build a brand new facility somewhere else, there's no contest. They've spent all this money to maintain a facility that you're going to simply mothball? There's no common sense or logic there at all."

Ah-Gwah-Ching has been on the chopping block for years. Both Govs. Arne Carlson and Jesse Ventura tried to shut it down. But each time, local lawmakers fought successfully to keep it open. The Legislature passed a law in 2000 requiring its approval before Ah-Gwah-Ching could be closed. Rep. Howes accuses the Department of Human Services of dodging the rules.

"Legislatively, they don't have the approval to close it," Howes said. "But legislatively, we can't stop them from emptying all the beds. Once all the beds are emptied, it's basically closed. It's their only way to circumvent current law."

Department of Human Services officials deny intentionally shrinking Ah-Gwah-Ching's population. Commissioner Kevin Goodno says fewer people are being sent there because community nursing homes have become better equipped to deal with difficult residents.

"There's a number of folks that in the past would have been referred to Ah-Gwah-Ching," said Goodno. "They're currently now being served in residential or community nursing homes, because that's what they're set up to do now. They've made that transition from providing for lesser acuity people to providing services to people with higher needs."

The sentences in our state are getting longer. More offenders are getting older while they're in prison, and are going to be in need of some of these long term care facilities. It's a huge, huge discussion that our policy makers are going to have to have.- Dept. of Corrections Commissioner Joan Fabian

Goodno says the trend in residential care puts people in smaller settings in their communities.

"About 60 percent of the population at Ah-Gwah-Ching are coming from the metropolitan area, mostly from Hennepin County," said Goodno. "And so the primary issue is providing services to people that are closer to their home and their family supports."

Ah-Gwah-Ching has fewer programs, and as a result some workers have lost their jobs. But local lawmakers are eyeing the facility as a place to care for a growing number of aging sex offenders.

The debate was triggered last month, when Attorney General Mike Hatch revealed the Department of Corrections was placing sexual predators in private nursing homes. Hatch filed suit against Concordia Care Center in Minneapolis. He alleges Concordia allowed several sex offenders to abuse other residents.

Corrections officials were taken by surprise. They weren't sure how many other sex offenders were living in private nursing homes, although Commissioner Joan Fabian now says that number is seven. Four are in Hennepin County and the others are in nursing homes in Redwood, Winona and Kanabec counties.

Fabian says Ah-Gwah-Ching is an option for some, but not all elderly offenders. Some don't meet the facility's admissions criteria. She says the state has to come up with new ways to deal with a growing number of older prisoners. The number of inmates over age 50 has more than doubled the past decade, and Fabian says that's just the beginning.

"The sentences in our state are getting longer. More offenders are getting older while they're in prison, and are going to be in need of some of these long term care facilities," said Fabian. "It's a huge, huge discussion that our policy makers are going to have to have... And I don't think anybody knows where it will go."

If state policy stays on track, Ah-Gwah-Ching will shut down. State officials say the facility will soon be listed as surplus property.

John Grimely, a former administrator of Ah-Gwah-Ching, is now working with state planners to come up with new uses for the property. So far, the options include a health care facility, a drug treatment center, or a regional jail. Grimely says the locals mostly want something that will provide good paying jobs.

"Everybody wants to see something continue here," said Grimely. "Whether it be a regional jail, or whether it be whatever, we just hope something can be done, because it would be a shame to have this facility in the shape that it is just go to waste."

Over the next two years, most remaining residents at Ah-Gwah-Ching will be moved to private nursing homes. State officials are still trying to figure out what they'll do with a few sex offenders still under control of the prison system. One plan would create a new, state-run nursing home for inmates, located somewhere in the Twin Cities.